Senior Pace – Volume ane, 2004 | Download PDF

by Kevin Carroll, MS, CP, FAAOP

Couple with snow ski gear smilingTake you lot heard the one about the 95-year-erstwhile lady who wears a prosthetic leg? She tin walk, bulldoze a motorcar, and leads a totally independent lifestyle. So, why does her son keeps pressuring her to move into a nursing abode? He'south getting lonely living there by himself!

It might sound like a joke, only information technology's a truthful story. And just one example of how older prosthesis users can do much more than survive – they tin can thrive. Clearly, those who are thriving have a number of important qualities in common.

Look Beyond Age

The saying, "Age is a state of mind," is important to people who lose a limb. They must try not to focus on age as the only measure of their power to recover. Age provides a way to count years, but it doesn't measure a person'due south eye, listen or motivation. Some people in their 80s accommodate to a prosthesis amend than others who are thirty years younger. The difference is one of expectation. People who expect to do well are generally people who take a stiff sense of purpose in their life – something across themselves that they feel is important.

I met a 97-year-onetime lady in Ohio who is responsible for three bully-grandchildren, ages 9, ten and 11. She gets them off to school every day, has dinner for them every evening, and also looks later her 80-yr-old son. Her expectation is that she is going to alive to be 115, and she probably will.

What exercise you expect for yourself? To be able to garden, to intendance for your family, to exist independent? Do your rehabilitation team and family also look a skilful outcome? Whether expectations are positive or negative, people tend to live up to them. Amputees and clinicians must await past stereotypes related to aging. You must expect that a positive outcome is possible whether y'all are 70, 80 or even 90 years onetime. The unproblematic fact is that Americans – including prosthesis users – are living longer, healthier lives than always before.

Often when people brainstorm wearing a prosthesis, their families and friends rally effectually them in a evidence of support. This plays an important part in the recovery procedure. It is as well important for new amputees to assert their independence. Well-significant loved ones tin can actually "kill with kindness" by doing too much for the new prosthesis user.

One thing I've observed is families who want to go older adults a powered wheelchair to help them out. A wheelchair can exist depressing to new amputees. Using a wheelchair can discourage them from making the try to walk and try other bones activities. I encourage people who are kickoff the rehabilitation procedure in a wheelchair to make getting out of the chair and up on their feet their No. one goal. And if they take to apply a wheelchair they shouldn't utilise one that's electrically powered. The upper-body move that'southward required to move a manual wheelchair is actually great practise.

Therapist helping senior woman walk between handrailsUnderstanding Functional Levels

Every consumer needs to understand how decisions are made regarding the blazon of components they tin can accept on their limb. Medicare has established guidelines that assign each person what's known as a "functional level."

  • Functional level 0 is assigned to a person with no power or potential to motion about or transfer.
  • Functional level ane is assigned to a person with the power or potential to transfer or move about on level surfaces at a fixed stride.
  • Functional level ii ways the person has the ability or potential to move about and can cross low-level barriers like curbs.
  • Functional level 3 is assigned to a person with the power or potential to walk at variable speeds.
  • Functional level 4 is reserved for exceptionally active individuals such every bit athletes and children.

A person's functional level is determined past the rehabilitation squad, which includes the physician, prosthetist and therapists. Older adults are typically assigned a functional level of ane or 2. As the functional level increases, then does the variety and sophistication of the prosthetic components that are available.

Over the years, I have seen many older adults go motivated to work harder on their rehabilitation when they understand how functional levels work. Permit's use prosthetic feet equally an case.

  • Individuals at functional level i can have the most basic, single-axis foot that is made.
  • At functional level 2, they can have a multi-axial pes and talocrural joint.
  • At functional level 3, they tin select from a range of lightweight, dynamic anxiety.

All prosthesis users should know their current functional level and ask their prosthetist what they can do to accomplish the next level. Older adults who start out at a functional level 1 may be able to work their way upward to a functional level of 2 or 3. The higher functional level volition give them the opportunity to larn avant-garde, lightweight components that can assistance increase their mobility.

Man holding a weight in each handGo Physical

Physical therapy is hard piece of work that is well worth the attempt. I recommend that older adults have physical therapy both earlier and after they get their prosthesis and schedule a return visit to their therapist each year. Therapy loosens upward the residual limb and increases musculus tone and coordination.

People who simply get once or twice and so stop are missing out on the existent benefits of physical therapy. It is of import to detect a physical therapist who has feel with prosthesis users.

I encourage new prosthesis users to attend up to x sessions of occupational therapy to

  • Become familiar with putting their prosthesis on
  • Learn to bath and dress themselves
  • Do other specific skills.

An occupational therapist can as well visit the habitation and aid modify the living surroundings.

Go on Things Light

Many important considerations go into the design of a prosthesis for an older adult. I of the near critical is its weight.

  • Older adults ordinarily have less strength and stamina and will function much improve with a lighter limb.
  • Legs that are too heavy cause users to feel a dragging sensation in every step, and, although they may get used to it, the weight is crushing and tiring.
  • The weight can discourage them from being active or from doing fifty-fifty simple things like going to the grocery store or to church.
  • Some people may stop wearing their prosthesis birthday if it feels too heavy and uncomfortable.
  • A heavy prosthesis also pulls on the skin of the residual limb. This is a special business concern for older adults since the elasticity of their skin has decreased, making information technology more fragile and susceptible to breakdown.

Each component of the older adult'due south prosthesis needs to exist as lightweight equally possible. Ask about the materials in the component and how they touch the weight. For example, carbon composites, titanium and aluminum are much lighter materials than wood and stainless steel.

Although at that place are many new and heady knees, pylons, feet and ankles available, some of these components may increase the weight of the prosthesis. Therefore, consumers should carefully consider the benefits of the more specialized components they are interested in versus the weight they are adding. An adaptable human foot that lets yous habiliment different heel heights may audio smashing, but how often volition you need that characteristic? If it'due south once or twice a year, is it worth carrying effectually a heavier foot the residue of the time?

People With Diabetes Exist Aware

Older adults with diabetes take to exist especially conscientious about the fit of their prosthesis.

  • People with diabetes oftentimes have a loss of sensation in their residual limb due to nerve damage or neuropathy. They may not know if their prosthesis is causing sore spots or pressure impairment because they are unable to feel it.
  • It is important for people with diabetes to examine the skin of their residual limb every day for potential signs of trouble. If they tin can't see the lesser of their residual limb, they should apply a mirror or inquire someone to help them.
  • People with diabetes must be diligent in their efforts to protect and monitor their rest limb as well equally their remaining sound foot.

Putting the Pieces Together

Older adults who are successful prosthesis users have several important qualities in common.

  • They are able to wait beyond age and expect to have a full and agile life.
  • In many cases, older adults with a good understanding of functional levels are able to button themselves to a higher level of rehabilitation. This increases their choices of prosthetic components.
  • Physical and occupational therapy are a central part of their recovery process.
  • These prosthesis users empathise why information technology'due south important to take a lightweight prosthesis.
  • They strive to be smart consumers in regard to prosthetic components and new technology.
  • Finally, because many older developed prosthesis users also have diabetes, they dedicate themselves to advisedly monitoring their balance limb and sound foot for any early signs of trouble.

With a positive outlook and a willingness to work at their recovery, older adult prosthesis users can truly thrive!